Mountain Comprehensive Health Corporation
Organization Active NPI Primary Care Clinic/Center · Harlan, KY
NPI 1316991979 · NPPES record last updated Apr 28, 2025
Key facts
- NPI
- 1316991979
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
- Practice address
- 132 Village Center Rd
Harlan, KY 40831-1777 - Phone
- (606) 573-7771
- Fax
- (606) 573-2809
- NPI assigned
- May 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. L.M. (Mike) Caudill
- Title
- Chief Executive Officer
- Phone
- (606) 633-4823
Owned or controlled facilities with NPI records 4
Other NPIs on the same Medicare enrollment 13
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 34
Practitioners 82
-
Nathan W Baker, MD
-
David Shane Barker, O.D.
-
Marye Margaret Campbell Boggs, MD,MPH
-
Van S Breeding, MD
-
Gregory Brian Dye, M.D.
-
Timothy Finn, OD
-
Bobbie Frederick, APRN
-
Mary Beth Hamilton, APRN
-
Salem Hanna, MD
-
Alexandra Dawn Hoskins, APRN, FNP-C
-
Carmen Jones, LCSW
-
Crystal Lee Jones, APRN
-
Jacob Nasser, D.P.M.
-
Shannon Rutherford, NP-C
-
Felicia Natasha Scott, LCSW
-
Sabrina Sergent, APRN
-
Katrina Renee Slone, D.O.
-
Jennie Sturgill, APRN
-
Sydney Caitlin Whitaker, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Federally qualified health center certification: CCN 181841
- Legal name
- MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jun 16, 2004
- Last certification
- Jun 16, 2004
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 14, 1972 in KY
- Enrollment address
- 132 Village Center
Harlan, KY 40831-1777
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Sherry Childers |
Corporate Director |
Jan 1, 2024 | |
| Steve Peake |
Corporate Director |
Jul 20, 2022 | |
| William Parks |
Corporate Director |
Jan 1, 2018 | |
| Jerry Hall |
Corporate Director |
Jan 1, 2022 | |
| Mike Caudill |
Corporate Officer |
Jul 1, 2005 | |
| David Adams |
Corporate Director |
Jan 1, 2024 | |
| Teresa Dotson |
Corporate Officer |
Sep 8, 2025 | |
| W-2 Managing Employee |
Sep 8, 2025 | ||
| Charles Colwell |
Corporate Director |
Jan 1, 2025 | |
| Gwen Johnson |
Corporate Director |
Jan 1, 2025 | |
| Jackie Colwell |
Corporate Director |
Jan 1, 2018 | |
| Teresa Hunter |
Corporate Director |
Jan 1, 2025 | |
| Mary Ann Sparks |
Corporate Director |
Jan 1, 2020 | |
| Paul Pratt |
Corporate Director |
Jan 1, 2023 | |
| Nanette Banks |
Corporate Director |
Jan 1, 2023 | |
| Robert Musick |
Corporate Director |
Sep 17, 2024 | |
| Carlana G. Mullins |
Corporate Director |
Jan 1, 2020 | |
| Kathy Hall |
Corporate Director |
Jan 1, 2024 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Mountain Comprehensive Health Corporation |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
| Letcher County Alternative Education School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
| Mountain Comprehensive Health Corporation |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
| Mountain Comprehensive Health Corporation |
Federally qualified health center | Operational/Managerial Control | Aug 1, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031224000024 | KY | Part B Supplier - Clinic/Group Practice | 7618875873 |
Receives reassigned benefits from 92 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Jeremiah, KY; Whitesburg, KY; Pineville, KY; Middlesboro, KY; Hindman, KY; Harlan, KY; Elkhorn City, KY; Cumberland, KY… |
| O20040525000685 | KY | Part a Provider - Federally Qualified Health Center (FQHC) | 7618875873 | Practice locations: Harlan, KY |
National Provider Directory
- Tax ID family
- MTN Comp Health Corp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | |||
| Primary Care Clinic/Center | 261QP2300X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
132 Village Center Rd
Harlan, KY 40831-1777
Mailing address
PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31000169 | Medicaid | KY |
Other names
- Harlan Medical Center
- Harlan-Bell Mobile Health Clinic
Other providers in Harlan, KY
- Jerry William McRoberts
- Kristin Nicole Meadors
- Mercy Ambulance of Evansville Inc
- Kimberly Michele Miller
- Crystal Dawn Miniard
- Mountain Comprehensive Health Corporation
- Mountain Medical Enterprises, PLLC
- Gail Murray
- Kristen Marie Nash
- Kimber Nolan
All providers in Harlan, KY · Primary Care Clinic/Center in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.